MedicaidCoverageLow impact
Alaska Medicaid Policy Update: Coverage of PIK3CA Genetic Testing
Alaska Medicaid·AK · Genetics, Pediatrics, Oncology·Policy Update
Effective date
Jul 1, 2022
We identified it
Jun 21, 2026
Summary
Alaska Medicaid now covers PIK3CA genetic testing (CPT 81309) for patients 2+ years old with clinical signs of PIK3CA-Related Overgrowth Spectrum being considered for FDA-approved treatment. Testing is limited to once per lifetime and requires specific documentation including a Genetic Testing Supporting Information form and lab report.
Action Required
Immediately: Billing team must ensure all PIK3CA genetic testing claims using CPT 81309 for Alaska Medicaid patients include both the required Genetic Testing Supporting Information form and lab report. Update billing procedures to verify patients meet all criteria (2+ years old, PROS clinical indications, considering FDA-approved treatment) and flag lifetime limit. Claims without proper documentation will be denied.